With home-based care providers across the country looking for solutions to staffing shortages and rising labor costs, it’s important to leverage technology for support. As the nation’s leading technology-driven HME billing and pharmacy reimbursement company, Prochant experts are here to offer workflow solutions.
Prochant Chief Revenue Officer Joey Graham has already outlined a couple workflow solutions, like decision support systems and patient portals. Now, he explains workforce automation and the areas that providers are utilizing it in today.
Why turn to automation for help?
“You need to create a system where people are able to work by exception. They're not working every single work item,” Joey explained.
“We've seen successful examples of automation throughout the healthcare revenue cycle. Everywhere from data entry of brand new patients to resupply, prior authorizations, and more. An e-referral can come in and actually populate the patient record, create a new order, index the document to that order.”
A lot is possible today to save your team time and your business money. Transform your revenue cycle with the proper automation services.
Examples of automations providers are currently using:
OCR automation: There's technology like OCR (optical character recognition) that will read machine-written text and reproduce that, typing everything up for you.
Robotic process automation: A service that can go to insurance websites and run eligibility to populate the information you need.
Automating your prior authorizations
“We've met with companies that have prior authorization automation in place,” Joey said. “For example, you have a system that's able to request authorizations either through web portals, faxes, or whatever the appropriate means of communication is based on the payer and the product.”
Services like this can even tell you when it comes across exceptions, or when it gets asked questions that it doesn't know the answer to. It can have you enter that information quickly, and then it continues the automation for you. Once again, your team is working by exception, and not having to work through every single authorization.
“Imagine, with software like that, a prior authorization representative could submit half a dozen authorizations at once, and then be there to manage the exceptions as they happen instead of managing every order confirmation one at a time.”
You can also automate order confirmations and cash posting
“All the major players have automated order confirmation in place,” Joey told us. “When they have confirmation of delivery, they confirm that order and manage it through the hold or let the claim drop.”
Auto-posting has also been out for a long time, but even automation for auto-posting has been developed. As with auto-posting, a bunch of exceptions still get generated. “You can actually leverage automation to manage the exceptions and get the majority of the auto-posted cash batches posted without human intervention.”
Automated resolution to the rescue
You should also have certain work queues that have automated resolution.
Example problem: You’re a provider who gets a lot of denials asking for a purchase invoice.
Solution: Use automation to make sending those purchase invoices easier and quicker. For example, once you have a file with all your purchase invoices for all your products, create an automated resolution so that when a denial comes in, the system responds by creating a cover letter and attaches the correct purchase invoice, firing off an appeal for you. No one in your office has to touch the denial. The automated response has done the job for you.
Of course, there are still exceptions where automation can’t be used, but you can have the majority of front- and back-office work be done in an automated fashion. The opportunities to use technology-driven solutions are only increasing. It takes work upfront to get everything in place, but once you get going, you’ll see your office workflow improve.
Stay up-to-date on our blog for more on workflow management. Want to explore modern billing and reimbursement solutions now? Reach out to Joey directly at (980) 999-4293 or email joeyg@prochant.com to see how Prochant can help simplify your business.
Prochant has DME/HME and pharmacy clients from all over the country and handles front-end and back-end billing functions. Our scalable solutions, years of experience, and advanced technology provide best-in-class results to the healthcare community. Headquartered in Charlotte, North Carolina, our client base includes national HME and pharmacy providers and health systems.